ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
Nucleus replacement could get a new chance with annulus closure.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed.
- A preliminary feasibility study of a tough hydrogel as a nucleus pulposus substitute for degenerative disc disease.Frontiers in bioengineering and biotechnology · 2026Article
- Biomechanical restoration in unilateral facet arthroplasty: a cadaveric evaluation.North American Spine Society journal · 2025Article
- Optimized hydrogel viscoelasticity and interlocking patch repair enhance compressive range of motion in injured discs and prevent re-herniation under physiological load in an Ex Vivo model.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- Article
- [Biomechanics of the intervertebral disc : Consequences of degenerative changes].Orthopadie (Heidelberg, Germany) · 2024Review
- Papain Injection Creates a Nucleotomy-like Cavity for Testing Gels in Intervertebral Discs.Gels (Basel, Switzerland) · 2024Article
- Comparison of four in vitro test methods to assess nucleus pulposus replacement device expulsion risk.JOR spine · 2024Article
- Utilization of Bone-Anchored Annular Defect Closure to Prevent Reherniation Following Lumbar Discectomy: Overcoming Barriers to Clinical Adoption and Market Access.International journal of spine surgery · 2024Article
- The Injection of Gels Through an Intact Annulus Maintains Biomechanical Performance without Extrusion Risk.Gels (Basel, Switzerland) · 2024Article
- Innovative design of minimal invasive biodegradable poly(glycerol-dodecanoate) nucleus pulposus scaffold with function regeneration.Nature communications · 2023Article
- AnJOR spine · 2023Article
- BionateJournal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2023Article
- Recent advances in the repair of degenerative intervertebral disc for preclinical applications.Frontiers in bioengineering and biotechnology · 2023Review
- Bionate Lumbar Disc Nucleus Prosthesis: Biomechanical Studies in Cadaveric Human Spines.ACS omega · 2022Article
- Finite Element Analysis of a Bionate Ring-Shaped Customized Lumbar Disc Nucleus Prosthesis.ACS applied bio materials · 2022Article
- Does the neutral zone quantification method matter? Efficacy of evaluating neutral zone during destabilization and restabilization in human spine implant testing.Journal of biomechanics · 2021Article
- Putting the Pieces in Place: Mobilizing Cellular Players to Improve Annulus Fibrosus Repair.Tissue engineering. Part B, Reviews · 2021Review
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
Abstract
purposeDisc herniations are usually treated by decompression of the spinal nerves via a partial nucleotomy. As a consequence of reduced disc height (DH), reduced intradiscal pressure (IDP) and increased range of motion (ROM), accelerated degeneration may occur. Nucleus replacement implants are intended to restore those values, but are associated with the risk of extrusion.
methodsIn six fresh frozen lumbar spinal segments (L2-3/L3-4/L4-5/L5-S1, age median 64.5 years (57-72), Pfirrmann grade 2-3), a prolapse was provoked through a box defect (6 × 10 mm) in the annulus. The herniated nucleus material was removed and replaced by a novel collagen-based nucleus implant. An annulus closure device sealed the defect. ROM, neutral zone (NZ) and IDP were measured in the (1) intact and (2) defect state, (3) postoperatively and (4) after cyclic loading (n = 100,000 cycles) applying pure moments (± 7.5 Nm) in flexion-extension, lateral bending and axial rotation. Additionally, the change in DH was determined. Extrusion of implants or nucleus material was evaluated macroscopically.
resultsIn all specimens, a prolapse could be provoked which decreased DH. Subsequent nucleotomy changed ROM/NZ and IDP considerably. Initial values could be restored by the implantation. Macroscopically, none of the implants nor nucleus material did migrate after cyclic loading.
conclusionsIn this study, a prolapse followed by a nucleotomy resulted in a biomechanical destabilisation. Implantation of the nucleus replacement combined with an annulus closure restored the intact condition without showing signs of extrusion nor migration after cyclic loading. Hence, nucleus replacements could have a new chance in combination with annulus closure devices.
Indexed as
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.